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Biomedical subjects

A Thiede

Publications and source records attributed to A Thiede.

At least 271 records · Page 15Linked to original sources
PubMed1984

[Technic of rectum anastomoses in rectum resection. A controlled study: instrumental suture versus hand suture].

Stapler and manual sutures in rectal end-to-end anastomoses were compared in a controlled trial. The following results were obtained: For the analysis the cases naturally separated into three groups, A (manual suture), B (planned stapler suture) and WD ("withdrawn" cases, from both groups, in which continence could be maintained only with a stapler suture). The distribution of the WD cases in dependence on localization and sex varied significantly from groups A and B, while A and B remained comparable, in spite of the WD cases. The analysis of the date showed no, or only slight, clinical differences. In a comparison of the two stapler groups B and WD, significantly more suture dehiscences, colocutaneous fistulae and post-operative disturbances in bladder function were found in group WD. As a general conclusion we can state that: In comparable anastomosis localizations it is possible to achieve almost the same clinical results with both suture techniques. With a circular stapler it is, however, technically possible to perform rectum resections in cases in which this was not previously possible, particularly in men with a narrow pelvis and a stale pelvic floor. To what extent this still is an advantage after the local recurrences are taken into consideration remains to be seen.

Clinical Trials as Topic↗
PubMed1984

[Anorectal continence following manual and mechanical anastomosis suture. Results of a controlled study of rectal surgery].

In a controlled clinical trial-manual vs. stapler anastomosis in rectal surgery-it was found that both suture techniques per se made no difference in the function of anal continence. The anal pressures at rest and sphincter contraction remained unchanged. A linear reduction of functional reservoir of the "neorectum" could be shown, which depended on the level and healing of the anastomosis. An anastomosis level at 6 cm from anocutaneous line is important for functional reasons. Anastomoses above this level do not cause any consequences for anal continence. Anastomoses below this level result in a reduced functional reservoir for at least 6 months. Within this period a decrease in anal continence is possible, especially in cases of disturbed healing of the anastomosis.

Adult↗
PubMed1983

[Pathophysiologic aspects, progressive and new developments in absorbable fully synthetic suture materials].

Polyglycolic acid (PGA) sutures and Polyglactin-910 sutures show only minimal tissue reaction, nearly no scar formation and no immunological reactions. PGA sutures of the third generation have the same advantages, but surgical handling is to much improved that they may be technically employed in unfavourable locations, e.g. gastrointestinal tract and respiratory organs. PGA sutures of the third generation and the new monofil Polydioxanon suture need special knot techniques.

Absorption↗
PubMed1983

[Polydioxanon (PDS)--a new monofilar synthetic, absorbable suture material. Tensile strength studies in a controlled clinical trial on the large intestine of humans and physical parameters in in vitro tests].

We investigated the properties of tensile strength for the following suture materials: Polyglycolic acid (2. and 3.generation), Polyglactin 910 (3.generation) and Polydioxanon. They were situated within human large bowels for 10 to 12 days and investigated in a controlled experimental procedure. The decrease of the tensile strength in the human large bowel is significantly slower for polydioxanon suture (PDS) than for PGA (2. and 3.generation) and Polyglactin 910 (3.generation) suture. As PDS-suture are primarily less tractable than the others, there is no significant difference of tractability between all sutures after 11 days of implantation within the human colon. For PGA (3.generation) and Polyglactin 910 we found a strong loss of tractability after 10 to 12 days. In a second experimental series tensile strength, knot breaking security and knot holding capacity were tested in a tensiometer for absorbable suture materials with 3 and 6 parallel knots. The tensile strength was higher than the knot security for all sutures. Coated suture material (PGA and Polyglactin 910, both 3.generation) as well as the new monofile polydioxanon must be knotted manyfold for a secure knot position.

Adult↗
PubMed1981

[Second generation of absorbable suture material. Tissue reaction and indication (author's transl)].

Polyglycolic acid (PGA) sutures have proved to be superior than other, nonabsorbable suture materials: a higher traction capacity and knot-tearing security, a defined and nearly linear decrease of traction capacity, no immunological reactions, very little capillarity, minimal tissue reaction, nearly no scar formation, and a bactericidal effect. PGA sutures of the second generation have the same advantages, but surgical handling is so much improved that they may be technically employed in unfavorable locations. In the surgery of gastrointestinal tract and respiratory organs there is a trend to connect all layers with one suture.

Absorption↗
PubMed1981

Vein replacement with fresh vital veins: a comparison of transplantation in RT-1-different rat strain combinations.

Transplantation of the intrathoracic inferior vena cava into the abdominal inferior vena cava of the recipient was performed in inbred rat strains of the following combinations: Syngeneic F344 leads to F344, RT-1-identical allogeneic LEW leads to F344, and RT-1-different allogeneic CAP leads to F344. In the RT-1-different combination subgroups with presensitization (blood, skin) were formed. The transplanted veins were evaluated at different times, macro- and microscopically. To test humoral immunology reactivity, we used a modified hemagglutination test, to analyse cell-mediated reactivity, subsequent skin grafts. The following results were obtained: 1) Aside from sporadic mononuclear cells caused by the operation technique, syngeneic vein grafts do not show any macroscopically visible and microscopically detectable changes. 2) Weakly allogeneic vein grafts do not lead to microscopically detectable changes in the graft. Strongly allogeneic vein grafts cause temporary mononuclear cell infiltration, which subsides within 21 days, without influencing the morphologic structure of the vessel wall. 3) In the RT-1-identical allogeneic strain combination, only accelerated skin graft rejection time indicates systemic sensitization, in the strongly allogeneic system, the increase of hemagglutinating antibodies also does this. 4) In both the RT-1-identical allogeneic strain combination and the RT-1-different allogeneic one, a proven sensitization does not lead to a permanent morphologic alteration. 5) Only presensitization with strong antigens (skin) leads to a macroscopically visible, as well as microscopically detectable, rejection reaction.

Animals↗
PubMed1981

[Systemic antibiotic prophylaxis in elective colon surgery. Results of a controlled study].

A prospective controlled, randomized trial was carried out among 70 patients undergoing elective colonic surgery; 31 patients received a systemic prophylaxis with cefotaxime (3 h) before surgery for 4 days and 29 patients were controls. The large bowel preparation consisted of whole gut irrigation with 0.9% NaCl and Paromomycin 1 g/l. Both groups were well matched after randomization. The rate wound infections in the control group was 28% and, in the test group, 6.4% (p less than 0.05, chi2-test). A trend toward a lower rate of urinary tract infections, an astomosic dehiscences and septicemic complications was recognizable in the test group, but not significant.

Aged↗
PubMed1981

[Value of circular mechanical colon and rectum anastomosis. Prospective study of 91 patients].

A prospective study was carried out on 91 patients to evaluate colonic and rectal anastomoses constructed with an EEA stapling gun. The concept comprises the following: orthograde lavage, cecal fistula or colostomy, intraoperative sufficiency control of the anastomosis, intraoperative direct measurement of the height of the anastomosis, postoperative X-ray control of the anastomosis using standardized techniques, classification of the cases into three groups according to the height of the anastomosis: 3-5 cm, and over 9 cm. Characterization of the patients was accomplished biostatistically using the Median-Quartil system. Primary hospital letality of 2% was due to heart failure. Imparied wound healing occurred in 11%. Secondary suture dehiscence was roentgenologically identified in a total of 18% of which only 7% showed clinical symptoms. Stenosis was determined by X-ray in 11% with only 1% demonstrating a temporary clinical correlation. For especially low rectal anastomoses at 3-5 cm the EEA stapling gun appears to have a great technical advantage over hand-placed sutures, allowing extension of indications for low anastomoses.

Adolescent↗
PubMed1980

[Controlled experimental histological and microbiological studies on the inhibitory effect of polyglycolic acid sutures in infections].

In the first experimental series, 3-0 PGS sutures which had been contaminated with staphylococcus aureus were situated in rat muscle in vivo. After periods of 20, 30, 40, 50, and 60 days, these sutures were removed and investigated histologically. After 20 days, the tissue surrounding the suture surface was much inflamed, showing inflammation cells and bacteriae, whereas after 60 days no signs of inflammation were to be seen. By hydrolysis of the PGS thread to the monomere glycolic acid, a bacteriostatic and bactericidal milieu seems to develop. In the second experimental series, purely in vitro, the fungicidal and bactericidal properties of glycolic acid were proved microbiologically. Furthermore, in two investigations PGS did not show fungicidal or bactericidal properties. When using PGS sutures, inhibition of the growth of fungi and bacteriae is based on the hydrolysis of PGS to glycolic acid.

Bacteria↗
PubMed1980

[In vivo studies on the tensile strength loss of absorbable synthetic threads].

In a total of eight experimental groups, PGS, PGS-S, PGS-C, and polyglactin 910 sutures were implanted subcutaneously in rats. The sutures were either sterile or contaminated with staphylococcus. They were removed after 7, 14, 21, and in two groups after 28 days. The linear loss of tensile strength was tested by means of an electronic tensile strength measuring machine. In four additional groups, the same studies were carried out with paraffinized PGS sutures and in localizations in stomach, duodenum and colon. The diameter of the filament has an effect on the loss of tensile strength: initially more rapid in fine filaments and later, retarded in comparison to thicker filaments. Coating of the suture has almost no influence on tensile strength, although contaminated sutures show a comparative decrease. In intraenteral localizations, loss of tensile strength can be expected to occur much more rapidly than in subcutaneous ones. Paraffinization does not delay decrease in tensile strength. Polyglactin 910 sutures of the second generation employed subcutaneously, show a much higher loss of tensile strength on the day 7 than PGS sutures; by day 28 the relationship is reversed.

Animals↗